| NPI | 1619334463 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BIN X WENG Owner 972-208-9998 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: TX 18039) |
| Enumeration Date | 2016-01-25 |
| Last Update Date | 2016-01-25 |